Ask an expert - body - head

92 questions

Q: Scalp acupuncture for child with cerebral palsy. i need a practitioner in UK with experience..in scalp acupuncture..

A: Scalp acupuncture is a fairly recent development, rather similar to ear acupuncture which was first introduced by Nogier in the 1950s. The main proponent of scalp acupuncture was a Japanese practitioner called Yamamoto, and there are a number of UK practitioners who use his techniques. More recently we have seen training courses run by Suzanne Robidoux who is explaining and promulgating the systems developed by a Chinese practitioner called Dr Feng.

In both these cases, however, the training is at postgraduate level, and there are no agreed standards for what counts as a 'scalp acupuncturist', and therefore no way that we could begin to recognise whom we could recommend. All that we can say is that if you use a search engine like google and type in 'scalp acupuncture' and your city or town, you may find someone who has trained in one of these systems.

which offer considerable encouragement, although we have to say that case studies stand a long way down the chain of evidence because there are so many confounding factors which might skew the results. That said, we are aware of considerable excitement amongst our members at the possibility that scalp acupuncture may offer a treatment for a number of intractable conditions like Parkinsons disease.

We always advise caution, though: if something is really effective its use tends to proliferate very quickly. We have seen a number of claims for the treatment of degenerative eye conditions, for example, in two clinics in USA and India but nowhere else. That said, this 'expert' had a go at being treated by someone who had just undertaken some training, and it was a remarkably powerful effect which, given some of the traditional points used, is not entirely a surprise.

It is best to be wary of unrealistic expectations, therefore, and the best way to address this is by having clear and measurable outcomes, and by setting clear review dates after each group of four or five sessions to see if there is or has been sustainable change.

A: We are always cautious about answering questions about conditions for which there has been little research evidence. The one summary of trials on the use of acupuncture for glaucoma really does not say very much

A part of the problem here, as the author of the review says, is that the standard method of testing procedures in the West, the randomised double blind control trial, involves one group getting a real treatment and the other group getting a sham treatment, to test the difference in outcome. No physician, however, would leave a condition like glaucoma untreated because of the potential for serious sight loss, so until someone tests the effects of standard treatment against standard treatment plus acupuncture there will be nothing definitive to point to.

All of us have treated people with glaucoma, either as a primary condition or as a secondary condition after a patient has presented with another problem, and I'm sure all of us can report some success. As the author of the review says, blockages in the flow of energy which prevent the free flow of fluids sums up what glaucoma is, and it would seem intuitively possible that acupuncture would have an effect. This expert's experience, though, has been that it takes a long time to achieve sustained and sustainable results, and the medications remain a part of the picture throughout. What acupuncture seems to do well is to prevent uncontrollable variations in pressure, but there is no statistical evidence to which we can point.

We have searched the internet and found surprisingly little patient feedback about the treatment of glaucoma with acupuncture. Most of the official charities and organisations do not have a great deal of feedback from patients on their websites, and we have not been able to trace many forums of sufferers. That these exist is not in doubt; the internet has created thousands of forums across the globe. The best that we can say is that if you search, you will find quite a few, and our experience is that they tend to be a great deal more measured than used to be the case. Where it used to be 'it works, oh no it doesn't' the entries now tend to reflect the wider range of outcomes and views.

We do not ourselves 'bank' feedback on specific conditions, primarily because we take the generalist view that we treat the person as much as or more than we treat the condition. However, our best advice as always is to go to see a BAcC member local to you for a brief face to face assessment. This will enable someone to see your problem not simply as it is but against the backdrop of your overall health. This will enable them to offer a much better view of what might be possible and also enrich any basic understanding of how your problem may have arisen from a Chinese medicine perspective.

On this basis we would always recommend that someone should visit a local BAcC member to seek a face to face assessment and also to try to understand the problem in its overall context in the body, not just as a specific manifestation. This is how Chinese medicine works, treating people not conditions.

What we would say, however, is that occasionally you come across websites for people treating eye conditions, especially two clinics in the USA and one clinic in India, which claim amazing success rates for these kinds of conditions. Our view is that if something was that effective we would all be doing it, so there may be something unique to the character of these set-ups which is driving such spectacular improvements. We tend to agree with the last answer; success can take a while, is always relative, and often reduces the impact of the condition more than totally removing it.

However, acupuncture will certainly not do any harm, and may well do some good.

Q: I have been diagnosed with ocular myasthenia and have been reading up about possible benefits of acupuncture treatment. I was wondering if I can get contact details about a good acupuncturists based in Edinburgh.

A: There is, as you might expect, not a great deal of evidence for the treatment of ocular myasthenia with acupuncture. We managed to find half a dozen case studies, mainly in Chinese and not translated, which showed some encouraging signs, but the reality is that small case studies only get published because they are the ones where treatment worked. As such, they are not reliable, because in single cases there are many other factors which might have had an impact. However, there was one study of more cases which seemed a great deal more positive, which you can read here:

are small in size and while suggestive of benefit a very long way from being conclusive evidence.

The trite answer we could give is that acupuncture treats the person, not the disease, and to the extent that all acupuncture treatment is geared to helping the body mind and spirit to normal function, then all conditions should, in theory, benefit from treatment. However, one has to be very careful with statements like this because it gives a false impression that all conditions are curable, which is clearly not the case. There are many debilitating diseases which are chronic and degenerative, for which the best one can say, as one patient famously did, is that they were 'very pleased because they were getting worse slower.'

The one advantage of Chinese medicine, however, is that it looks at the symptoms which patients experience through an entirely different diagnostic framework, one which can sometimes make sense of conditions in a way that conventional medicine cannot. Very few diseases are new, and Chinese doctors were probably treating this two thousand years ago without any concept of auto-immune disorders. they would simply have made sense of the presentation of the condition based on the understanding of the physiology in Chinese medicine and the pathologies which could arise when internal or external factors disturbed the flow of energy, or 'qi' as it is called, and led to organic malfunction.

Weakness and flaccidity of the muscles could be understood as a local or systemic problem, and the skill and art of the Chinese medicine practitioner lies in determining the most elegant and effective way to restore balance and good flow. It may be worthwhile asking a BAcC member local to you whether there is something obviously out of kilter in your system which might be contributing to the problems you have.

On balance, though, we have to be realistic and say that even anecdotal evidence is not that great, and what acupuncture may do, more than remove or reduce symptoms themselves, is to help you withthe secondary stresses and anxieties which the condition can engender. Many patients report this as an outcome which in itself makes treatment valuable.

We think that asking a local BAcC member for a view remains sound advice, and is probably a more realistic way of approaching the problem than by reference to a named condition occurring in different patients with different baseline constitutions. How your problem presents will be something which can inform a professional view far better than we can do here at this remove.

Q: My husband has been told that his eustachian tube in his ear remains open when it should be closed would he benefit from acupuncture?

A: We have spent some time researching your question about Patulous Eustachian Tube (PET) because we have to be honest and say that it is not a frequently presented problem. We have found no studies of its treatment with acupuncture, although we have no doubt that they exist in China. The problem is that only a very small percentage of studies are translated, and these are usually for the 'headline' named conditions, back pain, headaches, and so on.

From a Chinese medicine perspective, any failure of function should theoretically be amenable to treatment unless there has been a physical change in the structure of the body which it would be unrealistic to see reversed. As we understand it PET can range from a birth defect often found in people with Downs through to a shorter term problem generated by excessive weight loss and consequent loss of fat in the tissues of the Eustachian tubes. Depending on the putative cause treatment aimed at establishing the overall balance of the body may have a chance of restoring function to a degree. A practitioner might also be interested to see whether there are any local blockages in the flow of energy set against a general backdrop of energetic weakness which might have caused the condition to appear or worsen.

Generally, however, with conditions such as this there are fewer guarantees than usual, and we always recommend that treatment undertaken in a 'let's see' mode is carefully monitored. It is always worth trying acupuncture treatment because we have seen unexpectedly good results on occasion for conditions like this, but we have also seen situations where someone has had a course of twenty sessions with no change, and this can often lead to dissatisfaction. Regular review periods are essential.

The one small ray of hope is that there was some excitement about the use of a Chinese herb Jia-Wei-Gui-Pi-Tang following a Japanese study found here

http://web1.incl.ne.jp/ishikawa/PET/art1.html

which achieved some remarkable results in some patients, although the study itself was terminated because of adverse effects on other patients. We are not Chinese herbalists, but a small proportion of our membership are jointly members of the Register of Chinese Herbal Medicine (RCHM) and it may well be that if you can find a dual-registered practitioner near you, they might be able to offer you a very good assessment of what is possible by using a combination of acupuncture and herbs. There is also an association of mainly Chinese practitioners, the Association of Traditional Chinese Medicine, whose members all use acupuncture and herbs. Most members of all these associations are usually happy to give up a small amount of time to see someone briefly in order to assess whether treatment may be beneficial. This will enable a slightly more in-depth view than we are able to offer at this level of generality.

A: We find it quite difficult to answer questions about very specific problems like this. There is little or no research into problems like this, and where this is it tends to be in the form of case studies. These are interesting but offer far too many confounding factors to be able to draw any conclusions or recommendations. In modern times the advertising rules are now far too prescriptive to make claim without proper evidence (although we often argue with the ASA about what counts as 'proper'!)

However, symptoms are the same the world over, and in its 2500 year history there is a rich vein of addressing the pains and discomfort which people feel from problems like this by looking at their structure and appearance from within the framework of traditional Chinese medicine. This is an entirely different paradigm of medicine with patterns and syndromes which sound utterly alien to the untutored ear, but it has stood the test of time. If we drop disease labels out of the picture and focus on what someone experiences as a change in the balance and flow of energy, called 'qi', on which the system is based we often find local blockages and systemic weaknesses, the correction of which can make a significant difference.

Essentially Chinese medicine treats the person, not the condition, and the practitioner will want to understand why this particular symptom developed in this person. In this sense traditional acupuncture can help in the treatment of most named conditions, but we have to be careful because 'treat' implies 'cure', and this is often not the case. All that we can do is to maximise the balance of the individual and then let nature take its course. Sometimes the results are very good, on other occasions there are many hereditary and lifestyle issues which limit what is possible.

The best advice that we can give is that you visit a BAcC member local to you for an informal chat about the possible benefits of acupuncture. You will be able to let them know a great deal more about what exactly is happening, and this will offer the chance of a much better and more precise view than we can offer here. Most do not charge to have a quick look at a problem, and of course you get to meet them and see where they work before committing yourself to treatment.

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